Rhino-orbito-cerebral invasive fungal sinusitis associated with COVID-19 infection in a malnurished child

Abstract Background Corona virus disease has been associated with a wide variety of fungal and bacterial co-infections. These secondary infections could be due to the irrational use antibiotics, immunosuppressive therapy, pre-existing co morbidities, immune modulator effects virus. But here, we report very rare occurring rhino-orbito-cerebral invasive sinusitis in malnourished child no other morbidities. Case presentation This is case 6-year-old boy severe thinness co-morbidities, mild COVID-19 infection, during course illness developed sinusitis. The child’s mother had 1 week prior illness. then fever followed by headache. reported hospital on seventh day RTPCR for COVID-19, turned positive. vitals were stable maintaining saturation. Child was being treated supplements symptomatic treatment fever. On his second stay at hospital, he started develop gradually progressive left-sided peri-orbital swelling. Due association AMPHOTERICIN-B given 4 days referred higher center further management. Radiological imaging suggestive rhino-sinusitis orbital cellulitis meningeal enhancement etiology. Debridement done, adequately anti-fungal, showed significant improvement along radiological clearing. Conclusion Invasive infection can occur among pediatric age groups comorbidities.